vascular surgery board update · dr. ashraf mansour 2018‐2019 vsb vice chair dr. vivian gahtan...
TRANSCRIPT
4/1/2019
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Vascular Surgery Board of the American Board of Surgery
UpdateASH MANSOUR, M.D.
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Outline
● Board retreat
● Governance task force
● New members
● Continuous certification
● Exam results
www.absurgery.org
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Vision Statement of the ABS
Unify surgery in the
pursuit of excellence in
patient care.
THE AMERICAN BOARD OF SURGERY | www.absurgery.org
4/1/2019
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Mission Statement of the ABS
The American Board of Surgery serves the public
and the specialty of surgery by providing leadership
in surgical education and practice, by promoting
excellence through rigorous evaluation and
examination, and by promoting the highest
standards for professionalism, lifelong learning, and
the continuous certification of surgeons in practice.
THE AMERICAN BOARD OF SURGERY | www.absurgery.org
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History of the ABS● Founded in 1937 by the leading
surgical societies to differentiate formally trained surgeons from doctors in general practice
● Formed “to protect the public and improve the specialty”
● One of the first boards to institute recertification (1976)
● Continuous certification will help ensure future self‐regulation
THE AMERICAN BOARD OF SURGERY | www.absurgery.org
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The ABS Today● 31,000 current diplomates
● 3,300 are currently certified in vascular surgery
● 2,000 maintain both vascular surgery and general surgery certificates
● ABS is largest surgical board of the 24 member boards of the American Board of Medical Specialties (ABMS); in top third of largest ABMS boards overall
● For some issues, ABMS has proportional voting, with largest boards having most say
www.absurgery.org
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ABS Leadership – 2018‐2019
● Current Focus:
○ Improving continuous certification so it is more valuable to diplomates
○ Improving surgical training to better prepare graduating surgeons for practice
www.absurgery.org
Dr. Jo BuyskeExecutive Director
Dr. Craig Kent2018‐2019 Vice Chair
Dr. Spence Taylor 2018‐2019 Chair
Dr. John Mellinger2018‐2019 Vice Chair‐Elect
Both Dr. Taylor and Dr. Kent are vascular surgeons
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VSB Leadership – 2018‐2019
www.absurgery.org
Dr. Bruce PerlerABS Associate Executive
Director for Vascular Surgery
Dr. Ashraf Mansour2018‐2019 VSB Vice Chair
Dr. Vivian Gahtan2018‐2019 VSB Chair
● The VSB is the only ABS component board with its own associate executive director
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About the VSB● Vascular Surgery Board (VSB) founded in 1998
● Defines all requirements and processes related to
vascular surgery examination and certification
● VSB decisions are not subject to ABS BOD
approval
● Members are nominated from vascular surgery
societies for one 6‐year term
www.absurgery.org
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The VSB Today● Largest ABS component board, with 15 members and 2 permanent
representatives on ABS BOD
● By comparison, cardiologists have a component board, but no representation on ABIM BOD
● By being affiliated with ABS, larger voice in ACGME and ABMS affairs
● Takes advantage of ABS resources for exam development and delivery — 10+ ABS staff members support vascular surgery
● On its own, VSB would be 3rd smallest ABMS board. Similar sized boards (ABAI, ABNS, ABCRS) have 2x the fees of ABS
www.absurgery.org
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VSB Representatives● Historically, members of the VSB were elected from SVS, APDVS,
SCVS and VESS
● In 2016, VSB voted, with full ABS support, to add one board member from each of the 5 major regional societies:
● These additional representatives will help ensure that the voice of the entire vascular surgery community is heard
● New members have same duties and authority
New England Society for Vascular Surgery
Eastern Vascular Society
Southern Association for Vascular Surgery
Western Vascular Society
Midwestern Vascular Surgical Society
www.absurgery.org
Chair: Vivian Gahtan (SVS)
Vice-Chair: Ash Mansour (APDVS)
VSB Members Erica Mitchell (SVS) Dan Clair (SVS) Ron Dalman (SVS) Gib Upchurch (SCVS) Bernadette Aulivola (VESS) Mal Sheahan (APDVS) Vince Rowe (WVS) Keith Ozaki (NESVS) Tom Huber (SAVS) Marc Mitchell (EVS) Kellie Brown (MVSS)
Ex-Officio AED: Bruce Perler
Project Manager: Nicole Gifford
www.absurgery.org
ABS Board Officers from VSB Chair: Spence Taylor (SSA) Vice-Chair: Craig Kent (ASA)
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New Directors: June 2019● Vivian Gahtan
● Erica Mitchell
● Dan Clair
● Rabih Chaer
● Andy Schanzer
● Jason Lee
Vascular Surgery Board of Directors(15 Members)
Executive Governance Committee
Diplomates/LLL
Committee
Education & Training
Committee
Communications & Research Committee
VS CE
CommitteeVSITE
Committee
QE/LLL
CommitteeVSCORE
Consultant
QE/LLL Item
Writing Committee
Consultant
VSITE Item Writing
Committee
Consultant Writing
Committees 1, 2, 3
www.absurgery.org
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VSB Communications
● Goals ‐ Regular exchange of information between diplomates and the Board to advise of:
□ Value of board certification
□ Changes in method of certification
□ Function and role of the Board
□ Updates on certification process for new trainees
□ Updates on Continuous Certification for diplomates
● Be on the lookout for VSB‐written articles in Vascular Specialist
www.absurgery.org
Follow the VSB on Twitter!
@VSB_ABS
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ACGME – RC‐Surgery
● Collaboration with ACGME/RC‐Surgery
○ “Vascular Surgery Summit” held twice a year to discuss issues and ensure requirements are aligned
○ Thanks to VSB and ABS efforts, vascular surgery training programs at institutions without general surgery program are now permitted. To date no accreditation applications have been filed.
○ Have worked with ACGME/RC‐Surgery to allow 18 months of core surgery in vascular surgery residency rather than 24
www.absurgery.org
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Vascular Surgeons & Continuous Certification
● Vascular surgeons are a minority in the crowded field of specialists who treat vascular disease
BUT:
● Vascular surgery is the only specialty exclusively devoted to the diagnosis and treatment of vascular disease
● Vascular surgeons are the only specialists who provide the entire spectrum of treatment options: Medical, Open Surgery, Endovascular
● Vascular surgery board certification and continuous certification is the definitive measure of the vascular surgeon’s expertise in treating vascular disease and differentiates us from other specialists
www.absurgery.org
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What Patients Think
● 2010 Consumer Survey of 1,000 U.S. Adults
● Top 3 factors when choosing a doctor:
○ Bedside manner or communications skills (95%)
○ Board Certification (91%)
○ Recommendation from a friend or family member (83%)
● 95% said maintaining board certification is “important,” with 66% saying it is “very important”
www.absurgery.org
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Patients are checking
www.absurgery.org
“Check a Certification” feature on ABS website receives an average of 24,000 visits per month
“Check a Certification” feature on ABS website receives an average of 24,000 visits per month
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Why Change?
● ABS recognized that maintaining certification needed to be more convenient and more reflective of a surgeon’s practice
● Initial survey sent to thousands of diplomates in Fall 2016
● Survey results showed diplomates wanted a program that was more flexible and more practice‐related
Changes announced in early July 2017 to begin a new direction for continuous certification
www.absurgery.org
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Reporting Cycle
www.absurgery.org
Now in effect:
● 5‐year reporting cycle
○ Diplomates report every 5 years on professional standing, CME, and practice assessment activity
○ Reporting will remain an online process
○ Check your status anytime on ABS website
○ Transition period
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CME and Self‐Assessment● Once diplomates pass their first assessment, the CME and
self‐assessment requirement will change to:
125 CME credits over 5 years with no self‐assessment required
● CME must be related to your practice – no other limitation on subject matter
● CME completed for state board requirements qualifies
www.absurgery.org
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Other Program Requirements
● Full and unrestricted medical license
○ U.S. or Canada
● Hospital or surgical center privileges
○ If clinically active
● Two reference forms submitted every five years
○ To be completed by chair of surgery and chair of credentials committee where you perform most of your work
www.absurgery.org
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Other Program Requirements● Practice improvement
○ Ongoing participation in a local, regional or national outcomes registry or quality assessment program, either individually or through your institution
○ See ABS website for examples
● Operative log○ A 12‐month operative experience report (in any specialty),
to be submitted every 10 years
○ Data helps ensure exams reflect current practice
www.absurgery.org
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Practice improvement counts for MIPS
Participation in practice improvement also counts as an Improvement Activity for CMS QPP MIPS:
Source: ACS websitehttps://www.facs.org/qpp
www.absurgery.org
“Participation in Maintenance
of Certification (MOC) Part IV
for improving professional
practice, including participation
in a local, regional or national
outcomes registry or quality
assessment program.”
MIPS 2018
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Updating Your Status
● Diplomates are encouraged to maintain all of their information (e.g., privileges, CME, etc.) on an ongoing basis
● Check your status and submit information anytime by logging into the ABS website
www.absurgery.org
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New Assessment Process● New assessment process launched in 2018 for general surgery,
launching in 2019 for vascular surgery
● Specifically designed to respond to diplomates’ concerns
regarding the traditional recertification exam
● Diplomates with expiring certificates can use new process to
continue their certification
● Survey sent in August 2017 to all diplomates: Nearly 10,000
diplomates responded – 33% response rate
www.absurgery.org
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Feedback● August 2017 Survey Results:
○ 58% prefer a more frequent, open book, lower‐stakes assessments to the 10‐year model
○ 67% would like to complete the assessment no more frequently than every two years
○ For general surgery, are in favor of being tested on both core surgery (86%) and practice‐specific content (83%)
www.absurgery.org
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Vascular Surgery Assessment● A new assessment process for vascular surgery is launching in
2019 to replace the traditional recertification exam
○ 40 questions
○ Lower stakes
○ Required every 2 years
● VSB has convened a group of vascular surgeons in community and academic practice to write questions
● Content focuses on important developments in vascular surgery, to assist diplomates in staying up to date
www.absurgery.org
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Educational Format
● Take on own computer at home or office – no testing center!
● References and a list of topics will be published on ABS website in advance
www.absurgery.org
● Assessment has an educational format:
○ Open book
○ No time limit per question
○ Immediate learner feedback – view correct/incorrect with rationales
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Scoring● Second attempt to answer incorrect
questions will be offered at end of assessment
● Immediate results based on overall score (correct answers from 1st + 2nd attempts)
www.absurgery.org
● Must attain a total score of 80% (32 questions correct) after the two attempts to pass the assessment
o A score of at least 40% (16 questions correct) must be achieved on the first attempt to qualify for a second attempt
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Timing● Must pass one assessment every other year
● Time Limits
○ Two weeks to complete assessment once started
○ Can save results at any point and return later
○ If unsuccessful, can retake the assessment the following year (grace year)
○ If unsuccessful in grace year, must pass a secure exam
www.absurgery.org
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Assessment Feedback – ACS Communities
THE AMERICAN BOARD OF SURGERY | www.absurgery.org
“A positive learning experience. Some notable points.
1. I was able to take the test while on call.
2. The 40 test questions (20 core general surgery, 20 breast) were fair and very current.
3. It was easy to sign in an take the test. A quick video explains the process.
4. The test took me 4 hours to complete. I am a slow test taker and looked up information ("open book") while taking the test and studied the answer explanations, which were excellent. Immediate feedback was appreciated. Once you sign in you have two weeks to complete the test.
5. I learned pertinent information from this process which I can use in my practice.
6. I enjoyed taking this test, a positive learning experience...and I passed...
Thanks ABS for a job very well done.”
“In my opinion, the focus of this
new format is on learning and
highlighting relevant
information rather than just
testing. This recertification
process was a learning
experience, not just a testing
process. Very well done and
much appreciated.”
Just finished the recertification
process and test. I found it very
straight forward and THANK
YOU for no gotcha questions!!
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New Assessment Enrollment
● All current ABS certificates remain valid until expiration date
● Diplomates whose vascular surgery certificates expire in 2019
or later can use new assessment to continue their certification
● New vascular surgery diplomates (certified in 2018‐2019 or
thereafter) will be automatically enrolled in new process
● Registration for new assessment will open in the summer, with
the assessment offered over several weeks in the fall
www.absurgery.org
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Pathways for Lapsed Diplomates● Special time‐limited pathway for lapsed vascular surgery certificate
holders to regain ABS certification using the new assessment
○ Similar pathway available for those with lapsed general surgery certificates
● Must pass assessment 5 years in a row, as well as meet other program requirements
● This pathway will only be available for three years: 2019, 2020 and 2021
○ General surgery lapsed pathway available 2018, 2019, 2020
● After 2021, passing a secure exam will be required
○ After 2020 for general surgery
THE AMERICAN BOARD OF SURGERY | www.absurgery.org
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Annual Fee● Annual fee covers ongoing development of all aspects of the ABS
Continuous Certification Program:
○ Diplomate status tracking
○ Public reporting of diplomate status
○ Self‐service features like the CME Repository
○ New web‐based assessment process
● Annual Fee begins upon enrollment in new assessment process
○ Fee includes one assessment every other year
● ABS staff are working on a fee structure and a streamlined process to assist diplomates who maintain multiple certificates
www.absurgery.org
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Continuous Certification● Once enrolled in new assessment, a diplomate's certification
status will be contingent on passing the assessment every
other year, as well as meeting other program requirements
● Why?
○ Reflects rapid change in surgical knowledge and practice
○ More modern process of ongoing education and assessment
○ Provides greater assurance to patients that ABS‐certified surgeons are staying up to date
www.absurgery.org
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Advantages of New Assessment Program
● Evaluates knowledge and judgment that is more relevant to a diplomate’s practice
● Structured to highlight education with emphasis on changes in contemporary practice
● More convenience and flexibility
● Less burden to prepare, less anxiety to take
● Cost savings – no travel or time away from practice
● Maintains focus on improving patient care
www.absurgery.org
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Future Plans
● Beyond these efforts, the VSB and ABS will continue to work to make Continuous Certification more convenient and beneficial for diplomates
● Goal is a flexible process that supports diplomates and values their time and resources, while upholding our commitment to the public to maintain high standards
● Diplomates will be kept updated and surveyed regularly for their feedback
www.absurgery.org
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Certifying Exam 2019
● Will be in Philly
● May 20‐21
● Extra exam session Tuesday
● More examinees
www.absurgery.org
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Vascular Surgery QE Stats4/1/2019
Qualifying Examination
Year # Examinees Pass Rate
2012 123 90%
2013 136 93%
2014 141 94%
2015 165 94%
2016 156 92%
2017 162 97%
2018 171 90%
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Vascular Surgery CE Stats4/1/2019
Certifying Examination
Year # Examinees Pass Rate
2012 159 85%
2013 132 80%
2014 152 89%
2015 149 91%
2016 171 88%
2017 161 86%
2018 185 85%